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Thanks for your interest in our Gold Maintenance Package.
Upon recieving this form, we will contact you to
verify your account set up.*
After your Verification, we will simply bill you
your 1st month of Maintenance $19.95 (or pro rated amount)
Each month after that you will recieve a bill for $19.95
NO LONG TERM CONTRACTS, CANCELL AT ANY TIME !
IT'S  THAT EASY!
GOLD MAINTENANCE PACKAGE 
I have read and understand the TERMS & CONDITIONS.
First Name:
 Last Name:
Billing Address:
City:
State:
Zip Code:
  
Home Phone:
Work Phone:
e Mail:
I would like to be billed monthly @ $19.95
I would like to be billed yearly @ $199.50 (save $39.90)
I would like to use my credit card.
Your existing Domain Name: www.
Your existing hosting Company:
*by phone, e mail, or appointment. Depending on your location.
Legal Notices and Privacy Policy . Questions or Comments send to: info@budgetwebbuilders.com